Abdominal Exam

Question 1

What are common symptoms of upper abdominal symptoms? (7)

Answer 1

Dysphagia
Anorexia
Weight loss
Reflux
Dyspepsia
N&V
Haematemosis

Question 2

What are the common symptoms of lower abdominal disorder? (6)

Answer 2

Abdo pain
Wind
Rectal bleeding
Constipation
Diarrhoea
Incontinence

Question 3

Describe visceral pain

Answer 3

This is a poorly localised dull, deep, aching, cramping pain

Question 4

Describe somatic pain

Answer 4

A localised sharp, burning, throbbing, and dull ache

Question 5

What is McBurney sign positive?

Answer 5

A deep tenderness at McBurneys point. This is a sign of late stage appendicitis and may rupture

Question 6

How to test the psoas sign?

Answer 6

Whilst lying down if the patient flexes their right hip (lift their right leg against resistance) and they experience pain in the LRQ this is a positive psoas sign

Question 7

Why does someone with appendicitis experience pain when testing the psoas sign?

Answer 7

Because the iliopsoas muscle lies under the appendix. So aggrevating the iliopsoas with aggrevate the appendix

Question 8

How do you test for Rovsing sign?

Answer 8

When you palmate the lower left quadrant the patient will experience pain in the right lower quadrant

Question 9

How do you test for Rovsing sign?

Answer 9

When you palmate the lower left quadrant the patient will experience pain in the right lower quadrant

Question 10

How to test for the obturator sign in appendicitis?

Answer 10

Flex the leg at the hip and rotate the knee internally (bring the foot towards you) the patient in experience more pain in the LRQ

Question 11

What’s the Dumphy sign for appendicitis?

Answer 11

Abdo pain when you cough

Question 12

What are three causes for cyclical abdo pain for women (3)

Answer 12

Primary dysmenorrhoea
Endometriosis/adenomyosis
Mittelschmerz

Question 13

What are some causes for non cyclical abdominal pain in women? (4)

Answer 13

Uti
Pelvic inflammatory disease
Ovarian cyst accident
Adhesions

Question 14

What is duputrens contracture?

Answer 14

Chronically contacted fingers due to thickening of the skin in the hands

Question 15

What is a common term for asterixis?

Answer 15

Liver flap

Question 16

What is koilonychia?

Answer 16

Spoon shaped nails associated with iron deficiency

Question 17

What is leukonychia?

Answer 17

Whitening at the nail bed - associated with hypoalbuminaemia

Question 18

What is acanthosis nigricans?

Answer 18

Darkening and thinking if the arm pit skin.

It’s associated with insulin resistance, GI cancers or hormones are out of wack

Question 19

What is kayser-fleisher ring?

Answer 19

A copper ring around the iris accosicated with Wilson disease

Question 20

How many spider naevi is concerning and what is it associated with?

Answer 20

> 5 ans can be accosiated with liver cirrhosis

Question 21

What is caput medusa?

Answer 21

This is swollen veins found of the abdomen caused by an blockage of the portal vein

Question 22

What is Cullen sign?

Answer 22

Bruising around the umbilicus associated with haemorrhagic pancreatitis

Question 23

What are the 7 Fs of abdominal distension?

Answer 23

Fat, fluid, feotus, faeces, fibroid, full bladder, filthy big tumour

Question 24

How long should you listen to bowel sounds for ?

Answer 24

1-5 minutes

Question 25

What might be a cause for no bowel sounds?

Answer 25

Paralytic ileus
Intestinal failure
Generalised peritonitis

Question 26

What can cause high pitched and tinkling bowel sounds?

Answer 26

Sub acute intestinal obstruction

Question 27

When ausulating the organs. What are you listening for?

Answer 27

Bruits
Rubs
Venous hums

Question 28

When their is an increase liver during percussing. Why might their be?

Answer 28

Liver meglia or lung consolidations

Question 29

During percussion the liver appears decreased in size. Why might this be?

Answer 29

Due to cirrhosis, free air under the diaphragm or gas in the colon pushing on the liver (false decrease)

Question 30

What is the castells method?

Answer 30

This is when you percus for the spleen at the castell point (the last intercostal space) and the patient breaths in if there is a shift from resonance to dull this is a positive sign

Question 31

What is rebound tenderness?

Answer 31

When you get sudden abdo pain on rapid release of the abdo wall

Question 32

What is Murphy sign positive?

Answer 32

When you align with the right clavicular midpoint where the right abdominal rectus muscle intersects with the costal margin.
Palpate the gallbladder area, and as the patient breathes in, tip your fingers towards the gallbladder. A sudden pain suggests cholecystitis

Question 33

How do you palpate for the spleen?

Answer 33

Start at the right iliac fossa and move diagonally across the abdomen to the left costal margin.
Palpate like you could the liver. You shouldn’t feel the spleen normally

Question 34

When palpation the kidneys if you can feel them and are tender what might this suggest?

Answer 34

Hydronephrosis

Question 35

How do you test for ascites?

Answer 35

Shifting dullness

Question 36

During a digital exam, if a patients rectum is hypertonic. What might this suggest? (4)

Answer 36

Crohns
Fissure
Stricture
Nervous

Question 37

During a digital exam, if a patients rectum is hypotonic. What might this suggest? (3)

Answer 37

Old age
Nerve damage
Muscle damage

Question 38

What is a hernia?

Answer 38

An abnormal protrusion of a structure, irgan or part of an organ put of the cavity it belongs to

Question 39

What sort of hernia can’t you reduce?

Answer 39

Strangulation hernias